Learn / Should Medication-Assisted Treatment (MAT) Be Part of Your Recovery Plan?
Therapy alone isn’t the only way to approach recovery. For some people, a combination of medication and therapy might be the best option. This is exactly what medication-assisted treatment (MAT) does—and it works incredibly well for certain substance use disorders.
However, this evidence-based treatment technique for substance use does have its risks. For example, some medications used in this approach are addictive. It’s important to inform yourself about potential consequences so you’ll feel empowered when making decisions about your treatment plan. While you’ll work with a medical professional to customize your recovery strategy, it’s ultimately up to you whether or not you want MAT to be part of it.
Medication-assisted treatment1 is effective at treating some types of substance dependency. It can also prevent relapse and overdose, increase survival odds, and make it more likely that people will stay in treatment.
MAT achieves this by making the following happen:
But while this all seems promising, MAT only treats specific substance use disorders.
The FDA approves certain medications for each of these conditions. Which medication your doctor or psychiatrist prescribes you will depend on the condition you’re treating, as well as your medical and substance use history.
Disclaimer: The information below has been professionally reviewed but does not represent, nor should be mistaken for, medical advice. Please seek guidance from your doctor or qualified addiction treatment professional to fully review and understand the benefits, risks and side effects of the medications discussed.
MAT medications are most effective2 when people participate in a MAT program. While they’re not a remedy for alcohol misuse, they do temper withdrawal symptoms and help normalize brain and body functions.
This medication is best for people already in recovery from alcohol use disorder.3 While acamprosate stops people from drinking, it won’t prevent withdrawal symptoms if they do drink alcohol. Acamprosate can be taken on the 5th day of sobriety, and it takes 5 to 8 days to be completely effective.
Where can you find it? Patients must see a medical doctor to obtain a prescription.
Disulfiram causes an uncomfortable reaction to alcohol,3 which discourages patients from drinking. Because of this, only people who have stopped drinking alcohol should take this medication. It should also be avoided for 12 hours after alcohol use.
Where can you find it? Patients can take this prescription medication at home.
Is disulfiram effective? People are more likely to continue taking disulfiram for alcohol use disorder4 when doing so under supervision. This is because the unpleasant interaction with alcohol may deter people from taking this medication. Being aware of this consequence does stop some people from drinking.
MAT medications treat dependence on several different types of opioids,2 including heroin, morphine, codeine, oxycodone, and hydrocodone. You can use these medications long-term if necessary—some patients even do so indefinitely.
The goal of methadone treatment is to reduce opioid withdrawal symptoms and desire to use. Patients can work with their prescribing doctor to determine the right dosage and frequency. Methadone is usually most effective when used for at least 12 months.
Where can you find it? Patients need a prescription for methadone, and must begin taking it in the presence of a medical professional. However, after a period of progress, patients can use it at home.
Is methadone effective? According to experts, methadone is the current “gold standard” in MAT for opioids.6 However, this might just be because it’s been in use the longest (for the past 50 years). Regardless, research shows that methadone does work for many people. According to one study, methadone has a 60% success rate in helping people stay abstinent from opioids,6 along with the “greatest results in retention rates” as compared to buprenorphine and naltrexone.
Patients must stop using opioids 12 to 24 hours before starting buprenorphine. It’s possible to lower dosage from every day to alternate days after seeing improvements. Studies show that patients who use buprenorphine for longer amounts of time8 at a higher dosage (at least 16mg) are less likely to relapse.
Where can you find it? Patients can get a prescription for buprenorphine from a doctor, and take it in a clinic or the comfort of their own home.
Is buprenorphine effective? While experts consider buprenorphine the “second-best choice” in MAT after methadone, it’s still very effective for many people. For example, one study found that 60% of people remained abstinent from opioids when using buprenorphine6 as compared to no medication or a placebo.
One medication, naltrexone, treats both alcohol and opioid misuse.2 This newer medication was originally just for opioid use disorder. However, after 2 different studies determined that it also reduced the number of drinking days and relapse rates, the FDA also approved it for alcohol use disorder.4
People won’t feel the euphoric effects of alcohol or opioids with naltrexone,9 and it decreases their desire to engage in substance use. Because of this, people are less likely to drink or use opioids, and more likely to continue treatment. Patients taking naltrexone for opioid misuse need to wait 7 days after taking short-acting opioids and 10 to 14 days for long-acting opioids.
Where can you find it? Healthcare providers prescribe naltrexone.
Is naltrexone effective? Naltrexone results vary. One study determined that naltrexone was the least successful overall6 as compared to methadone and buprenorphine. Another study concluded that naltrexone only had a “moderate effect” on decreasing alcohol use.4 However, another study found that it significantly reduced the number of days of alcohol usage and relapse rates.
Naloxone is a medication that reverses opioid overdose.10 This medicine doesn’t work for non-opioid overdoses. The patient may require more than 1 dose of naloxone11 if they used large quantities of opioids, or stronger opioids like fentanyl. While all naloxone devices are effective,12 research suggests that FDA-approved units administer greater blood levels of naloxone.
Where can you find it? Naloxone is widely available, and most pharmacies carry it. Many states don’t require a prescription. Community programs and local public health organizations may also have naloxone.
For the most part, yes—as long as they are used as directed. But unfortunately, it is possible to misuse them. People can take too much, or not enough, for them to be effective.
And, medications like methadone and buprenorphine can be habit-forming. Some people even take MAT medications for opioid dependency for their entire lives. This begs the question: is MAT just substituting one drug with another?
Unfortunately, the answer to this question is complicated. Addiction experts have widely different opinions on the matter. Alex Azar, the U.S. Health and Human Services Secretary from 2018 to 2021, was very much in favor of MAT.15 According to Azar, “Medication-assisted treatment works. The evidence on this is voluminous and ever-growing.” He added that failing to offer MAT to patients is “like treating an infection without antibiotics.”
However, Tom Price, U.S. Health and Human Services Secretary in 2017, argued the opposite. According to Price, “If we’re just substituting one opioid for another, we’re not moving the dial much.”
Regardless of this dispute, many medical professionals believe that MAT is an essential part of the recovery process. Your answer will depend on your own personal beliefs and experiences—and what advice makes the most sense for you.
A good starting point for determining your course of action is to get an assessment. You can do this through your primary care physician or via a treatment center. Together, you can evaluate your options, weigh the pros and cons each, and decide what’s best for your situation.
Find out more about rehab facilities that offer MAT, including insurance coverage, reviews, contact information, and more.
Reviewed by Rajnandini Rathod
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